Mascia Giuseppe, Arbelo Elena, Hernandez-Ojeda Jaime, Solimene Francesco, Brugada Ramon, Brugada Josep
Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy.
Cardiology Department, Hospital Clínic, IDIBAPS, Arrhythmia Section, University of Barcelona (Spain), Barcelona, Spain.
Int J Sports Med. 2017 Jul;38(8):573-581. doi: 10.1055/s-0043-107240. Epub 2017 Jun 18.
Since its recognition as a clinical entity in 1992, the Brugada Syndrome (BrS), a hereditary disease characterized by a typical electrocardiogram (ECG) pattern potentially predisposing to sudden cardiac death (SCD), has attracted the attention of many physicians for its circadian pattern of ventricular arrhythmias (VA), mostly occurring at rest. Exercise may potentially worsen the ECG abnormalities in BrS patients, resulting in higher peak J-point amplitudes during the vasovagal reaction of the recovery period, possibly leading to an increased risk of cardiac events. Moreover, the enhanced vagal tone in athletes could be both a BrS risk factor and an exercise effect. Therefore, the true risk of a BrS patient during exercise is still unclear. This review summarizes current knowledge, shortcomings and open questions on BrS and exercise. The paper, in particular, underlines specific considerations including BrS diagnostic criteria and differential diagnosis in athletes, the genetic basis, the autonomic imbalance during exercise practice and the recommendations for athletic participation in this patient group.
自1992年被确认为一种临床实体以来， Brugada综合征（BrS）作为一种遗传性疾病，其特征是具有典型的心电图（ECG）模式，可能易引发心脏性猝死（SCD），因其室性心律失常（VA）的昼夜节律模式（大多发生在休息时）而引起了许多医生的关注。运动可能会使BrS患者的心电图异常恶化，导致恢复期迷走神经血管反应期间J点峰值幅度更高，可能会增加心脏事件的风险。此外，运动员迷走神经张力增强可能既是BrS的危险因素，也是运动的一种效应。因此，BrS患者在运动期间的真正风险仍不明确。本综述总结了关于BrS与运动的当前知识、不足和未解决的问题。本文特别强调了一些具体考虑因素，包括运动员的BrS诊断标准和鉴别诊断、遗传基础、运动实践中的自主神经失衡以及对该患者群体参与运动的建议。
